Recherche Images Maps Play YouTube Actualités Gmail Drive Plus »
Connexion
Les utilisateurs de lecteurs d'écran peuvent cliquer sur ce lien pour activer le mode d'accessibilité. Celui-ci propose les mêmes fonctionnalités principales, mais il est optimisé pour votre lecteur d'écran.

Brevets

  1. Recherche avancée dans les brevets
Numéro de publicationUS5601607 A
Type de publicationOctroi
Numéro de demandeUS 08/376,805
Date de publication11 févr. 1997
Date de dépôt23 janv. 1995
Date de priorité19 mars 1992
État de paiement des fraisCaduc
Numéro de publication08376805, 376805, US 5601607 A, US 5601607A, US-A-5601607, US5601607 A, US5601607A
InventeursTheodore P. Adams
Cessionnaire d'origineAngeion Corporation
Exporter la citationBiBTeX, EndNote, RefMan
Liens externes: USPTO, Cession USPTO, Espacenet
Implantable cardioverter defibrillator housing plated electrode
US 5601607 A
Résumé
A defibrillator for pectoral implant in a patient wherein the metal housing or case of the defibrillator is utilized as an electrode and is operative to supply electrical pulses. The housing is coated with an oxidation resistant material to optimize electrode function.
Images(9)
Previous page
Next page
Revendications(11)
The invention claimed is:
1. An implantable cardioverter defibrillator system comprising a pulse generator, a lead connecting said pulse generator to a first electrode whereby an electrical pulse generated by said pulse generator is conducted to said first electrode, a second electrode, said second electrode comprising an external area of said pulse generator, said external area being in electrical contact with pulse generation circuitry of said pulse generator wherein a pulse generated through said first electrode is discharged against said second electrode, said external area being coated with an oxidation resistant material.
2. The system of claim 1, further comprising electrical insulation material coveting selected areas of said pulse generator.
3. The system of claim 1, further comprising a third electrode and lead therefor, said third electrode connected to said pulse generator by said lead and being dischargeable against said second electrode.
4. The system of claim 3, wherein said third electrode is a patch electrode.
5. The system of claim 4, wherein said patch electrode is a subcutaneous patch electrode.
6. The system of claim 3 wherein said first and third electrodes are transvenous electrodes.
7. The system of claim 3 wherein said system further comprises a transvenous catheter carrying said first and third electrodes, said catheter being in electrical connection with said pulse generator.
8. The system of claim 1, wherein said pulse generator is implanted subcutaneously in the left pectoral region of a patient.
9. The system of claim 1, wherein said second electrode is aimed inwardly into a patient's body towards the heart.
10. The system of claim 1, wherein said oxidation resistant coating material comprises a noble metal.
11. The system of claim 10, wherein said noble metal is platinum.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation in part of U.S. patent application Ser. No. 08/321,782, filed Oct. 12, 1994, now U.S. Pat. 5,447,521, which is division of Ser. No. 854,862, filed Mar. 19, 1992, now U.S. Pat. No. 5,376,103, both of which are incorporated herein by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to implantable cardioverter defibrillator (ICD) systems, and particularly to the electrodes and pulse generators thereof. The invention provides optimal materials for constructing pulse generator housings for use as an electrode.

2. Description of the Prior Art

The departure of the heart from normal action to uncoordinated and ineffectual contractions, "fibrillation," can lead to death within minutes unless corrected. One method of treatment to restore the normal heart action involves passing electrical current through the heart muscle. The effectiveness of such treatment is dependent on a number of factors, including the location of the electrodes used to apply the electrical current, the shape of the electrodes, and the magnitude, timing, and waveform of the current. While all these factors are significant, a fundamental problem of all such electrical treatments arises from tile fact that they all require large currents to accomplish defibrillation. And, because the heart muscle typically presents an electrical impedance in tile range of 40 to 100 ohms, signal amplitudes of several hundred volts are required to obtain the necessary current. The requirements for relatively high voltage and several-ampere currents combine to place great importance on efficient, low-resistance electrode arrangements for delivering tile defibrillation signal to the heart. Ideally the electrode would have no resistance itself and would be placed directly against the heart muscle to avoid the voltage drop across the tissue that surrounds the heart.

Various approaches to the optimal electrode, implanted in the body, have been attempted. For example, tile epicardial-patch electrodes comprise conductive and relatively large- surface area elements stitched directly onto the exterior of the heart. While this approach is satisfactory from an electrical standpoint, the attachment of the electrodes requires a major surgical procedure.

Another approach, the transvenous technique, utilizes a conducting filament threaded through an opening in a vein, and into the heart interior. When the filament coils up in a heart chamber, ideally against the chamber wall, a relatively large-area contact to tile cardiac muscle can be made. This approach requires that two such electrodes be used, one in the right-atrium (RA) position or in the nearby superior vena cava (SVC) position, and the other placed at the right-ventricular-apex (RVA) position. Despite the fact that transvenous electrodes can be inserted with a relatively simple surgical procedure, they have a serious shortcoming. Because of the design constraints that permit them to be threaded through the blood vessels, they cannot be depended upon to make adequate contact with the interior wall of the heart, and therefore they sometimes do not direct adequate current through a sufficient portion of the heart-muscle volume to achieve defibrillation.

Another option is to combine a transvenous electrode with a subcutaneous patch (SUB). This approach implants a shallow, just-under-the-skin conductive element of appreciable area on the patient's left side to serve as an electrode, as illustrated in FIG. 2. Since the patch is not directly on the heart, current must pass through the intervening body tissue and fluid to reach the heart. The resistance of the intervening tissue and fluid requires the application of a higher voltage to achieve the desired current through the heart muscle, and the passage of tile current through the intervening material may lead to patient discomfort. Additionally, while the surgical procedure for implanting the subcutaneous patch is relatively minor compared to that required for implantation of electrodes directly against the heart muscle, it still presents some risk to the patient. Although the subcutaneous-patch approach provides the advantage of simpler and less risky surgery, the proximity of a subcutaneous patch to the body's surface leaves the electrode relatively unprotected, and as a result, such electrodes have been subject to flexure and breakage from mishaps, and even from normal body motions.

A final option is to utilize the pulse generator itself as an electrode. Because of the relatively high voltage and substantial currents involved in treatment, the size and weight of an implanted pulse generator (PG) is an important factor in defibrillation. The package or outer shell of the PG is usually a sealed housing made of titanium, selected for its relatively light weight and corrosion resistance. The weight of the PG is normally in excess of 200 grams, or approximately one half pound. The patient abdominal cavity is normally the chosen implantation site for space and comfort reasons. However, implantation of tile PG nearer the heart, for example in the pectoral region, provides the advantage of a more efficient system which in mm allows the size of the PG to be reduced. PG implantation near the heart also permits use of the metallic PG housing as an electrode, also called a "Can". This is, in a sense, a "free" electrode in that the housing is required in any case. Implanting the PG pectorally involves surgery little more invasive than that required to implant a subcutaneous patch. Furthermore, it eliminates the troublesome requirement for tunneling wires under the skin that accompanies the subcutaneous patch. and the PG is also not subject to crumbling and breakage. It is possible to use the PG enclosure as an electrode in combination with electrodes of the prior art, such as the RVA, SVC and subcutaneous-patch (SUB) electrodes. This facilitates the use of sequential defibrillation pulses having different spatial axes, demonstrated in the prior art to reduce the amount of energy needed for defibrillation (i.e. lower defibrillation threshold). Energy consumption is a vital concern since it is directly related to size and therefore also implantability.

Known "active can" electrode designs have been found to be less than optimal due to oxidation of the can material. Insofar as is known, no device has been made or proposed which solves this problem as applicant has.

SUMMARY OF THE INVENTION

The invention provides system and electrode design that is more reliable and more efficient than those of the prior art. The present invention involves optimizing the material used in tile pulse generator housing to improve its function as an electrode in the defibrillator system.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a schematic representation of a defibrillating system of the prior art implanted in the abdominal cavity, and having epicardial-patch electrodes attached directly to tile heart;

FIG. 2 illustrates a schematic representation of a defibrillating system of the prior art having one transvenous electrode and one subcutaneous-patch electrode;

FIG. 3 illustrates a schematic representation of a defibrillating system of the present invention having a SVC electrode, an RVA electrode and one subcutaneous-patch electrode;

FIGS. 4, 5 and 6 illustrate schematic representations of a defibrillating system of the present invention having a PG housing with one major metallic face exposed to serve as an electrode, and the balance of the PG surface area covered by an insulating layer;

FIGS. 7 and 8 illustrate schematic representations of a defibrillating system of the present invention having a PG housing with approximately half its surface-area exposed to serve as an electrode and the balance of the PG surface area covered by an insulating layer;

FIG. 9 illustrates a schematic representation of a defibrillating system of the present invention incorporating a selector switch that permits the PG to serve either in the PG-housing-as-electrode mode or in other conventional modes;

FIG. 10 illustrates a schematic representation of a defibrillating system of the present invention incorporating one possible safety circuit that disables the pulse generator when the housing-to-circuit-common resistance is higher than that encountered by the system after implantation, thus protecting medical personnel who must handle the system before and during implantation;

FIG. 11 illustrates a monophasic waveform that in the present invention is applied to a novel set of electrodes in novel patterns;

FIG. 12 illustrates a biphasic waveform that in the present invention is applied to a novel set of electrodes in novel patterns;

FIG. 13 illustrates a sequential-pulse waveform that in the present invention is applied to a novel set of electrodes in novel patterns;

FIG. 14 illustrates a chart of useful polarity patterns for three electrodes, RVA, SVC and CAN, describing the cases of monophasic and first-biphasic-pulse waveforms;

FIG. 15 illustrates a chart of additional polarity patterns for use in sequential-pulse waveforms in the three-electrode case;

FIG. 16 illustrates a chart of three- and four-electrode pattern combinations useful in sequential-pulse defibrillation;

FIG. 17 illustrates a chart of useful polarity patterns for four electrodes, RVA, SVC, CAN and SUB, for the cases of monophasic and first-biphasic-pulse waveforms; and

FIG. 18 illustrates a chart of additional polarity patterns for use in sequential-pulse waveforms in the four-electrode case.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

Recent developments in defibrillator, electrode and lead designs have demonstrated that lower defibrillation thresholds are achievable with transvenous leads where the ICD can is implanted in the left pectoral region and used as an electrode. This position, along with an electrode in the right ventricle, yields a current vector that transverses the critical areas of the heart.

The ICD can makes a suitable electrode because of its large surface area. However, known designs still do not provide optimal electrode function. Known cans are constructed of titanium or stainless steel. The unidirectional current flow from these cans causes the titanium to oxidize, thereby increasing impedance and allowing plating of metal frown one electrode to the other. This permits an unacceptably large potential for change of original electrode characteristics.

Future devices will undoubtedly be smaller and deliver less energy. It is therefore desirable to optimize the performance of the can as an electrode. The can material cannot easily be changed to a different material with better electrode properties because the characteristics that make the can suitable as an electrode may make it unsuitable for use as a structural element, for example its function as a hermetic sealing element and as an EMI barrier.

The present invention involves coating the entire ICD can, or in the alternative, predetermined portions of the can, with a coating to reduce the effects of oxidation of the can material over a time period with multiple shocks. Oxidation of the can may cause changes in the impedance, polarization and appearance of the can. The coating comprises a noble metal based substance. The coating preferably comprises platinum Platinum coating has been demonstrated to give superior electrode performance compared to prior an titanium and stainless steel. The coating may be accomplished by plating, vapor deposition, cladding, or welding. The can may be completely coated. Alternatively, selected areas may be coated, either in a pattern, such as a grid, or continuously. Selective coating is desirable in a can design where two can parts are welded together so that the coating doesn't interfere with the welding process. Such interference may cause poor welds or create new alloys at the weld seam that may promote corrosion.

A primary aspect of the present invention is to use the PG-housing electrode both in lieu of the subcutaneous-patch electrode and as an augmentation to it, providing either two, three, or four electrodes. Both cases permit a variety of pulse-sequence and pulse-axis combinations, with the second term referring to the spatial direction of the discharge, fixed by polarity and electrode choices.

In pectoral implantation of a PG, the entire PG exterior may be employed as an electrode. This provides a large electrode area, and hence a small parasitic contact resistance. While the low contact resistance is a desirable goal, the system could pose a serious shock hazard to medical personnel handling it before and during implantation. Also, this arrangement would not allow steering the current in a desired direction.

The application of an insulating layer to portions of the PG's external surface largely eliminates tile shock hazard and provides the beneficial result of allowing the current to be steered in a direction most advantageous for defibrillation. The PG housing desirably approximates a somewhat flattened rectangular parallelepiped. This geometry allows most of one major face of the housing to serve as the electrode, with the balance being insulated, as is illustrated in FIGS. 4, 5 and 6. Because the four smallest faces, or edges, as well as one major face, of the PG are insulation-covered, safe handling of the PG is comparatively straightforward and can be accomplished without risk to the surgeon during implantation. A further benefit of this arrangement is that the electrical discharge can be aimed in a chosen direction. For example, aiming the discharge toward the interior of the body causes primary current conduction to avoid the skin, which largely avoids the additional discomfort normally accompanying and electrode not in direct contact with the heart. On the other, hand, aiming the discharge away from the interior of the body causes the path length, and hence parasitic resistance, to increase, but causes less skeletal muscle "jerk". By this is meant a reflexive contraction of skeletal muscles in tile path of the electrical discharge, and stimulated by it, with uncomfortable, and possibly injurious results.

As a further option, another portion of the PG housing could be covered with an insulating coating, as shown in FIGS. 7 and 8. The ease and safety of handling of this configuration approximates that for the preceding option, but additionally provides a wider range of aiming options due to the increased number of surfaces which are not insulated.

While tile conductive PG housing will be most advantageously used in the pectoral implant, it can also be used in conventional abdominal implantation by adding a single-pole, single-throw selector switch to the system, as shown in FIG. 9. When selector switch 94 is open, as in FIG. 9, the metal housing of the PG is isolated from all circuitry, and tile PG may be conventionally implanted in the abdominal cavity. But when selector switch 94 is closed, the PG housing is activated as the CAN electrode. By the simple act of plugging in the lead from a SUB electrode, and/or an RA electrode, tile surgeon can realize various electrode-pattern options to accompany the pectorally implanted CAN electrode.

In the event that further protection against shock is desired, this invention provides a circuit, shown in FIG. 10, for sensing that the implantation procedure has not yet been performed and develops a disabling signal to prevent inadvertent generation of the defibrillation signal. This feature totally eliminates tile shock hazard to medical personnel. It can be viewed as a safety element that augments the exterior insulation described above.

It is evident that combining the PG-housing or CAN electrode with the well-established defibrillation electrodes SVC and RVA, that are often associated with a cardiac catheter, makes possible a number of polarity patterns for applying defibrillation pulses. Beyond this, is the choice of the monophasic pulse pictured in FIG. 11, the biphasic pulse in FIG. 12, and the sequential pulses in FIG. 13. Let it be said that the two pulses in the biphasic waveform, as well as in the sequential waveform are of comparable amplitude and duration, thus avoiding the infinite possible waveform variations. Let "comparable" be taken to mean "within a factor of four".

Consider first the monophasic pulse. Taking the three electrodes in sequence P-VA, SVC, and CAN, FIG. 14 identifies four polarity patterns that are useful. The number in the left-hand column identifies the pattern. The plus and minus symbols indicate the relative polarities of the respective electrodes during discharge, and the zero symbol means that the circuit to the corresponding electrode is open, or else that the electrode is otherwise omitted from the systems. It will be seen that options assigning a zero to the RVA electrode are omitted, because the RVA electrode plays a dominant role in directing current through the bulk of the left-ventricular muscle. Furthermore, it has been found that assigning the same polarity to the RVA and SVC electrodes, that is, making them electrically common, is an ineffective option. Note that simple polarity reversal has been treated as a separate pattern. That is, pattern 3 is the reverse of 1, and 4 is the reverse of 2. Finally, the case with the CAN electrode open or removed is omitted because it reverts to the prior art.

Next, the four patterns in FIG. 14 may be interpreted as a description of the first pulse in the biphasic waveform of FIG. 12. Thus, FIG. 14 deals fully with both the monophasic and biphasic cases. The case of two pulses in sequence involves additional considerations. First, identify a given sequential-pulse option by using tile pattern identification numbers. Thus, "12" would mean that tile first pulse is of pattern 1, and the second, pattern 2. It has been found that two same-pattern (and otherwise similar) pulses in a sequence are not beneficial. In tile sequential-pulse representation of FIG. 13, different polarity patterns are assumed for the two pulses. Therefore, tile sequence options 11, 22, 33 and 44 are dropped from consideration. Next, a sequence involving simple polarity inversion on all electrodes in going form the first pulse to the second is also omitted because this simply constitutes one of the biphasic options. This removes 13, 31, 24 and 42. Next, consider that a pattern eliminating the RVA electrode may be useful as one of the two sequential pulses, even though it is not useful in the monophasic case. There are two such patterns given in FIG. 15, and numbered 5 and 6. Thus, it is possible to list exhaustively all useful pattern combinations in the sequential case, as has been done in FIG. 16.

When a subcutaneous-patch or SUB electrode is present in addition to the RVA, SVC, and CAN electrodes, the list of patterns must be reconsidered. Once again, a pattern with RVA and SVC common is rejected for the same reason as before. Further a pattern with CAN and SUB having opposite polarities is rejected because the current from one to the other would be remote from the heart and wasted. In addition, a pattern with CAN open is avoided because it constitutes prior art, and a pattern with SUB open is also avoided because such cases have already been treated in FIGS. 14, 15 and 16. Thus, there are four patterns again this time, as given in FIG. 17. Again, there are two additional patterns that are potentially useful in the sequential case, as given in FIG. 18. Because the symmetries in FIGS. 17 and 18 are identical to those in FIGS. 14 and i 5, it follows that FIG. 16 give the useful pattern combinations for the case of four electrodes, as well as for the case of three electrodes.

FIG. 1 illustrates a schematic drawing of a patient 10 fitted with a defibrillating system of the prior art consisting of a PG 12 implanted in the abdominal cavity and connected to epicardial-patch electrodes 14 and 16 by electrical-lead harness 18.

FIG. 2 illustrates a schematic drawing of a patient 20 fitted with a defibrillating system of the prior art consisting of a PG 22 implanted in the abdominal cavity and connected to transvenous RVA electrode 24 and subcutaneous-patch electrode 26 by means of electrical-lead harness 28 where all numerals correspond to those elements previously described.

FIG. 3 illustrates a schematic drawing of a patient 30 fitted with a defibrillating system of the present invention comprising a pectorally implanted PG 32, a subcutaneous-patch electrode 34, and transvenous catheter 36, carrying an SVC electrode 38, and an RVA electrode 39 where all numerals correspond to those elements previously described.

FIG. 4 illustrates the top face 40 of a PG 42 having an insulating layer 44 that covers the entire top surface of the PG exterior where all numerals correspond to those elements previously described.

FIG. 5 illustrates an elevation of a PG 42 having an insulating layer 52 that covers the entire surface of the face 50 depicted, and also covers the remaining three "edge" faces where all numerals correspond to those elements previously described.

FIG. 6 illustrates the bottom face 60 of the PG 42 having an insulating layer 62 that covers only the periphery of the bottom major face 60, leaving the balance 64 of the bottom face 60 within the periphery of the insulating layer 62 to serve as an exposed-metal electrode.

FIG. 7 illustrates a side view of a PG 72, including a plurality of faces 70a-70n, having an insulating layer 74 that covers a significant fraction of the exterior surface of the PG 72, leaving the balance 76 consisting of faces 70a-70n of the exterior surface of the PG 72 in the form of exposed metal to serve as an electrode.

FIG. 8 illustrates a top view of the PG 72 and the insulating layer 74 that covers a significant fraction of the faces 70a-70n, leaving the balance 84 consisting of faces 70a-70n in the form of exposed metal to serve as an electrode.

FIG. 9 illustrates a PG module 90 and represents schematically certain of its internal elements that permit flexible application of the system where all numerals correspond to those elements previously described. The pulse-generator circuit 92 has a first output lead 93 connected through the externally controlled SPST selector switch 94 to the PG housing 95 at the connection point 96. When the switch 94 is open, the PG module 92 can be abdominally implanted in conventional fashion; when the switch 94 is closed, the PG housing 95 can be employed as a defibrillation electrode in the case of pectoral implantation. The first output lead 93 is also connected to a first self-sealing output jack 98 into which an SVC electrode lead can be plugged when desired, as well as to a second self-sealing output jack 100 into which a SUB electrode can be plugged when desired. A second output lead 10 1 from the pulse-generator circuit 92 is permanently connected inside a lead 102 that is intravenously installed to place an electrode in the RVA position. Activation of an SVC electrode is accomplished by plugging its lead into jack 98, and activation of a SUB electrode is accomplished by plugging its lead into jack 100. With these options, in addition to that provided by selector switch 94, it is evident that the flexibility of the present invention offers the choice of three single-electrode options, of three common-double-electrode options, and one common-triple-electrode option, for a total of seven options for an electrode pattern to deliver a shock directed at the opposing RVA electrode that is connected to the pulse-generator circuit 92 through the lead 102.

FIG. 10 illustrates a PG module 110 that incorporates a safety circuit for disabling the pulse generator until the system has been implanted where all numerals correspond to those elements previously described. The safety circuit senses when the system has been implanted by monitoring the resistance between the implanted RVA electrode 134 and the metal housing 130 of the system. When the resistance drops to a low level, the system develops a signal that allows defibrillation pulse to be passed to the CAN or PG-housing electrode.

When the pulse generator 140 is prepared to deliver its pulse or other waveform it closes SPST switch 112 by conventional circuit means. Closing SPST switch 112 causes current from low-voltage power supply 114 to flow through a center-tapped 1-megaohm resistor, that is through resistors 116a and 116b. This creates a reference voltage, having a value one half that of the output from the low-voltage supply 114, to be developed across resistor 116a, and causes the centertap 118 to become a reference terminal.

The reference voltage at the centertap 118 is fed to a first, positive, input terminal 120 of comparator 122. A "test" voltage, responsive to the resistance between the CAN electrode metal housing 130 and the RVA electrode 134 is applied to a second, negative, input terminal 124 of comparator 122. This voltage is derived from a voltage divider consisting of a 500-ohm resistor 126 as the "upper" element, and as the "lower" element, the resistance 128 existing at that time from the metal housing of the PG or CAN electrode 130 to the common terminal 132 of the high- and low-voltage circuits, which is also common to the RVA electrode 134. It will be appreciated that, while FIG. 10 illustrates the resistance between the CAN electrode 130 and the RVA electrode 134 as a resistor 128 shown in dotted lines, in actuality, the resistance is not a discrete resistor, but rather the resistance of the path that exists at the time between these electrodes. Before the device is implanted, the path will be largely air and have a very high resistance. However, after implantation, the path will be through relatively highly conductive body tissue, and therefore, have a relatively low resistance.

Even when a person is handling the system, and holding the metal housing of the system in one hand and the RVA electrode in the other, the resistance between circuit points 130 and 134 (from hand to hand) is typically several kilohms, so that the test voltage at negative input terminal 124 is much more positive than the reference voltage at positive input terminal 120, so that the comparator delivers a logical "low", or zero voltage at output terminal 136. This output signal controls the switch 138, and zero voltage to that switch, which is preferably an FET, meaning that the switch is inactivated and hence open. With switch 138 open, the defibrillation pulses from pulse generator 140 are blocked and do not reach the CAN or housing electrode 130.

When the PG module 110 is properly implanted, the electrical path represented by the resistor 128 from the housing electrode 130 to the RVA electrode 134 will lie through body tissue and have a resistance value well below 500 ohms, causing the reference voltage at positive input terminal 120 to be more positive than the test voltage at negative input terminal 124, causing the comparator to switch to the logical "high" condition at output terminal 136. This high signal at comparator output terminal 136 causes switch 138 to close, thereby permitting the normal delivery of the defibrillation pulses from pulse generator 140 to the metal housing 130.

The safety circuit operates for all CAN electrode 130 configurations without modification and functions to prevent accidental shock regardless of the selected pulse polarity. Thus, the medical team is protected in all situations where the shock hazard is present and the safety feature imposes no limitations on the electrode selection, the choice of pulse polarity, or other options such as the pulse sequence or waveform. Further, it is evident that the PG module 110 and its circuitry of FIG. 10 can be combined with the PG module 90 and its circuitry of FIG. 9 by combining the switches 138 and 94 into one switch operable by either of two means.

FIG. 11 illustrates a defibrillation waveform 150 known in the prior art as monophasic that hi tile present invention is applied to a novel set of electrodes in novel patterns.

FIG. 12 illustrates a defibrillation waveform 160 known in the prior art as biphasic that in the present invention is applied to a novel set of electrodes in novel patterns.

FIG. 13 illustrates a defibrillation waveform 170 comprising a pair of sequential pulses that in the present invention is applied to a novel set of electrodes in novel patterns.

FIG. 14 illustrates a chart set 180 of useful polarity patterns for defibrillation using three electrodes: right-ventricular apex (RVA); superior vena cava (SVC); and PG housing (CAN). The set 180 omits patterns that have been found ineffective. The plus and minus symbols indicate relative polarities of the respective electrodes during discharge, and the zero symbol means that the circuit to the corresponding electrode is open, or that the corresponding electrode is otherwise removed form the system. The set 180 is applicable to a monophasic waveform, and to the initial pulse of a biphasic waveform.

FIG. 15 illustrates a chart set 190 of additional polarity patterns for defibrillation using the RVA, SVC and CAN electrode patterns that are for use in one of the pulses in a two-pulse sequential waveform.

FIG. 16 illustrates a chart set 200 of twenty-four pattern combinations for use in sequential-pulse defibrillation. Each digit in the chart refers to the corresponding polarity pattern defined in FIGS. 14 and 15, and each pair of digits represents a sequential-pulse option for two pulses in the case of three electrodes as in FIGS. 14 and 15, and for the case of four electrodes as in FIGS. 17 and 18 which follow.

FIG. 17 illustrates a chart set 210 of useful polarity patterns for defibrillation using the RVA, SVC, CAN and SUB (subcutaneous-patch) electrodes. The set 210 omits patterns that are know to be ineffective, and is applicable to a monophasic waveform, and to the initial pulse of a biphasic waveform.

FIG. 18 illustrates a chart set 220 of additional polarity patterns for defibrillation using the RVA, SVC, CAN and SUB electrodes, patterns that are for use in one of the pulses in the two-pulse sequential waveform.

As many changes are possible to the embodiments of this invention utilizing the teachings thereof, the descriptions above, and the accompanying drawings should be interpreted in the illustrative and not the limited sense.

Citations de brevets
Brevet cité Date de dépôt Date de publication Déposant Titre
US4440178 *23 déc. 19813 avr. 1984Kontron AgImplantable electrode
US4502492 *28 avr. 19835 mars 1985Medtronic, Inc.Low-polarization low-threshold electrode
US4708145 *11 sept. 198524 nov. 1987Medtronic, Inc.Sequential-pulse, multiple pathway defibrillation method
US4727877 *12 août 19861 mars 1988Medtronic, Inc.Method and apparatus for low energy endocardial defibrillation
US5014696 *15 déc. 198814 mai 1991Medtronic, Inc.Endocardial defibrillation electrode system
US5074313 *20 avr. 199024 déc. 1991Cardiac Pacemakers, Inc.Porous electrode with enhanced reactive surface
US5107834 *30 janv. 199128 avr. 1992Cardiac Pacemakers, Inc.Low energy multiple shock defibrillation/cardioversion discharge technique and electrode configuration
US5178957 *2 juil. 199112 janv. 1993Minnesota Mining And Manufacturing CompanyNoble metal-polymer composites and flexible thin-film conductors prepared therefrom
US5209229 *20 mai 199111 mai 1993Telectronics Pacing Systems, Inc.Apparatus and method employing plural electrode configurations for cardioversion of atrial fibrillation in an arrhythmia control system
US5360442 *4 janv. 19931 nov. 1994Cardiac Pacemakers, Inc.Subcutaneous defibrillation electrodes
US5376103 *19 mars 199227 déc. 1994Angeion CorporationElectrode system for implantable defibrillator
Citations hors brevets
Référence
1Guyton et al., "Capacitor Electrode Stimulates Nerve or Muscle without Oxidation-Reduction Reactions," Science, vol. 181, pp. 74-76, 607/121.
2 *Guyton et al., Capacitor Electrode Stimulates Nerve or Muscle without Oxidation Reduction Reactions, Science, vol. 181, pp. 74 76, 607/121.
Référencé par
Brevet citant Date de dépôt Date de publication Déposant Titre
US5931863 *20 mai 19983 août 1999Procath CorporationElectrophysiology catheter
US6112118 *28 juin 199729 août 2000Kroll; Mark W.Implantable cardioverter defibrillator with slew rate limiting
US629547413 mars 199825 sept. 2001Intermedics Inc.Defibrillator housing with conductive polymer coating
US644950626 juin 200010 sept. 2002Biontronik Mess-Und Therapiegeraete Gmbh & Co. Ingenieubuero BerlinMultiphase defibrillator with conductive housing
US6539257 *12 sept. 200025 mars 2003Uab Research FoundationMethod and apparatus for treating cardiac arrhythmia
US671862826 févr. 200113 avr. 2004Intermedics Inc.Method of making a stimulator electrode with a conductive polymer coating
US67788605 nov. 200117 août 2004Cameron Health, Inc.Switched capacitor defibrillation circuit
US6788974 *27 août 20017 sept. 2004Cameron Health, Inc.Radian curve shaped implantable cardioverter-defibrillator canister
US68342045 nov. 200121 déc. 2004Cameron Health, Inc.Method and apparatus for inducing defibrillation in a patient using a T-shock waveform
US685683527 août 200115 févr. 2005Cameron Health, Inc.Biphasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US68568403 août 200115 févr. 2005Intermedics, Inc.Ionically conductive polymeric composition
US68654175 nov. 20018 mars 2005Cameron Health, Inc.H-bridge with sensing circuit
US686604427 août 200115 mars 2005Cameron Health, Inc.Method of insertion and implantation of implantable cardioverter-defibrillator canisters
US69277215 nov. 20019 août 2005Cameron Health, Inc.Low power A/D converter
US693790727 août 200130 août 2005Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with low-profile installation appendage and method of doing same
US695070527 août 200127 sept. 2005Cameron Health, Inc.Canister designs for implantable cardioverter-defibrillators
US69526085 nov. 20014 oct. 2005Cameron Health, Inc.Defibrillation pacing circuitry
US69526105 nov. 20014 oct. 2005Cameron Health, Inc.Current waveforms for anti-tachycardia pacing for a subcutaneous implantable cardioverter- defibrillator
US69546705 nov. 200111 oct. 2005Cameron Health, Inc.Simplified defibrillator output circuit
US6987999 *2 mai 200217 janv. 2006Pacesetter, Inc.Implantable defibrillator with alternating counter electrode
US69880035 nov. 200117 janv. 2006Cameron Health, Inc.Implantable cardioverter-defibrillator having two spaced apart shocking electrodes on housing
US7039459 *5 nov. 20012 mai 2006Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US703946527 août 20012 mai 2006Cameron Health, Inc.Ceramics and/or other material insulated shell for active and non-active S-ICD can
US70432995 nov. 20019 mai 2006Cameron Health, Inc.Subcutaneous implantable cardioverter-defibrillator employing a telescoping lead
US7065407 *27 août 200120 juin 2006Cameron Health, Inc.Duckbill-shaped implantable cardioverter-defibrillator canister and method of use
US70654105 nov. 200120 juin 2006Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthorasic conduction
US7069080 *27 août 200127 juin 2006Cameron Health, Inc.Active housing and subcutaneous electrode cardioversion/defibrillating system
US70762941 mars 200411 juil. 2006Cameron Health, Inc.Method of implanting ICD and subcutaneous lead
US707629627 août 200111 juil. 2006Cameron Health, Inc.Method of supplying energy to subcutaneous cardioverter-defibrillator and pacer
US70906825 nov. 200115 août 2006Cameron Health, Inc.Method and apparatus for extraction of a subcutaneous electrode
US70927545 nov. 200115 août 2006Cameron Health, Inc.Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US71204955 nov. 200110 oct. 2006Cameron Health, Inc.Flexible subcutaneous implantable cardioverter-defibrillator
US71204969 juil. 200410 oct. 2006Cameron Health, Inc.Radian curve shaped implantable cardioverter-defibrillator canister
US714621227 août 20015 déc. 2006Cameron Health, Inc.Anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US71812749 nov. 200420 févr. 2007Cameron Health, Inc.Methods for inducing fibrillation utilizing subcutaneous electrodes
US71910099 août 200413 mars 2007Medtronic, Inc.Means for increasing implantable medical device electrode surface area
US719430217 avr. 200220 mars 2007Cameron Health, Inc.Subcutaneous cardiac stimulator with small contact surface electrodes
US71943033 févr. 200520 mars 2007Cameron Health, Inc.H-bridge with sensing circuit
US7194309 *5 nov. 200120 mars 2007Cameron Health, Inc.Packaging technology for non-transvenous cardioverter/defibrillator devices
US72399254 mai 20043 juil. 2007Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with improved installation characteristics
US72489211 juin 200424 juil. 2007Cameron Health, Inc.Method and devices for performing cardiac waveform appraisal
US727496221 mai 200425 sept. 2007Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthoracic conduction
US72990926 mai 200420 nov. 2007Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with low profile installation appendage
US72990976 mai 200420 nov. 2007Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with insertion tool
US730230019 mars 200427 nov. 2007Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with highly maneuverable insertion tool
US733075727 mai 200412 févr. 2008Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US734639231 janv. 200318 mars 2008Uab Research FoundationMethod and apparatus for the monitoring and treatment of spontaneous cardiac arrhythmias
US735975414 oct. 200515 avr. 2008Cameron Health, Inc.Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator
US736308322 avr. 200522 avr. 2008Cameron Health, Inc.Flexible subcutaneous implantable cardioverter-defibrillator
US737645829 nov. 200420 mai 2008Cameron Health, Inc.Method for defining signal templates in implantable cardiac devices
US73797728 juin 200427 mai 2008Cameron Health, Inc.Apparatus and method of arrhythmia detection in a subcutaneous implantable cardioverter/defibrillator
US738913912 sept. 200517 juin 2008Cameron Health, Inc.Simplified defibrillator output circuit
US739208527 juil. 200424 juin 2008Cameron Health, Inc.Multiple electrode vectors for implantable cardiac treatment devices
US740635029 sept. 200529 juil. 2008Cameron Health, Inc.Subcutaneous implantable cardioverter-defibrillator employing a telescoping lead
US74284372 sept. 200523 sept. 2008Cameron Health, Inc.Canister designs for implantable cardioverter-defibrillators
US74441822 mai 200528 oct. 2008Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US746392421 janv. 20059 déc. 2008Cameron Health, Inc.Methods for determining placement of an implantable cardiac stimulus device
US747793529 nov. 200413 janv. 2009Cameron Health, Inc.Method and apparatus for beat alignment and comparison
US749975017 déc. 20033 mars 2009Cardiac Pacemakers, Inc.Noise canceling cardiac electrodes
US750264518 févr. 200510 mars 2009Cameron Health, Inc.Current waveforms for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US75229577 juin 200521 avr. 2009Cameron Health, Inc.Defibrillation pacing circuitry
US75362229 nov. 200419 mai 2009Cameron Health, Inc.Nonvascular implantable defibrillator and method
US755533826 avr. 200530 juin 2009Cameron Health, Inc.Methods and implantable devices for inducing fibrillation by alternating constant current
US75709978 avr. 20044 août 2009Cardiac Pacemakers, Inc.Subcutaneous cardiac rhythm management with asystole prevention therapy
US762390926 mai 200624 nov. 2009Cameron Health, Inc.Implantable medical devices and programmers adapted for sensing vector selection
US76239131 août 200624 nov. 2009Cameron Health, Inc.Implantable medical devices using heuristic filtering in cardiac event detection
US762391620 déc. 200624 nov. 2009Cameron Health, Inc.Implantable cardiac stimulus devices and methods with input recharge circuitry
US762392030 juin 200524 nov. 2009Cameron Health, Inc.Low power A/D converter
US76273672 mai 20051 déc. 2009Cameron Health, Inc.Multiple electrode vectors for implantable cardiac treatment devices
US762737512 juin 20061 déc. 2009Cameron Health, Inc.Implantable cardiac stimulus methods
US76550146 déc. 20042 févr. 2010Cameron Health, Inc.Apparatus and method for subcutaneous electrode insertion
US76573116 juin 20062 févr. 2010Cameron Health, Inc.Subcutaneous only implantable cardioverter-defibrillator and optional pacer
US76573225 mai 20062 févr. 2010Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthoracic conduction
US7668597 *31 mars 200623 févr. 2010Medtronic, Inc.Feedthrough array for use in implantable medical devices
US772053428 sept. 200618 mai 2010Cameron Health, Inc.Transthoracic impedance measurement in a subcutaneous device
US77205366 juin 200618 mai 2010Cameron Health, Inc.Power supply for an implantable subcutaneous cardioverter-defibrillator
US775188527 oct. 20066 juil. 2010Cameron Health, Inc.Bradycardia pacing in a subcutaneous device
US776944527 févr. 20073 août 2010Cameron Health, Inc.Implantable cardioverter-defibrillator with post-shock reset
US778334016 janv. 200724 août 2010Cameron Health, Inc.Systems and methods for sensing vector selection in an implantable medical device using a polynomial approach
US778794617 sept. 200431 août 2010Cardiac Pacemakers, Inc.Patient monitoring, diagnosis, and/or therapy systems and methods
US78137976 févr. 200612 oct. 2010Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US785331814 mars 200714 déc. 2010Cardiac Pacemakers, Inc.Cardiac sensing by implantable medical devices during magnetic resonance imaging
US787341228 févr. 200718 janv. 2011Cardiac Pacemakers, Inc.Induced current measurement systems and methods
US787713922 sept. 200625 janv. 2011Cameron Health, Inc.Method and device for implantable cardiac stimulus device lead impedance measurement
US79791228 avr. 200412 juil. 2011Cardiac Pacemakers, Inc.Implantable sudden cardiac death prevention device with reduced programmable feature set
US799145916 nov. 20072 août 2011Cameron Health, Inc.Method for defining signal templates in implantable cardiac devices
US799607221 déc. 20049 août 2011Cardiac Pacemakers, Inc.Positionally adaptable implantable cardiac device
US800255318 août 200323 août 2011Cardiac Pacemakers, Inc.Sleep quality data collection and evaluation
US801485126 sept. 20066 sept. 2011Cameron Health, Inc.Signal analysis in implantable cardiac treatment devices
US801485614 déc. 20106 sept. 2011Cardiac Pacemakers, Inc.Induced current measurement systems and methods
US8112152 *4 mars 20097 févr. 2012Medtronic, Inc.Feedthrough apparatus with noble metal-coated leads
US81168674 août 200514 févr. 2012Cameron Health, Inc.Methods and devices for tachyarrhythmia sensing and high-pass filter bypass
US81313694 mars 20096 mars 2012Medtronic, Inc.Feedthrough apparatus with noble metal-coated leads
US816069725 janv. 200517 avr. 2012Cameron Health, Inc.Method for adapting charge initiation for an implantable cardioverter-defibrillator
US81606998 oct. 201017 avr. 2012Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US82003417 févr. 200712 juin 2012Cameron Health, Inc.Sensing vector selection in a cardiac stimulus device with postural assessment
US822956325 janv. 200524 juil. 2012Cameron Health, Inc.Devices for adapting charge initiation for an implantable cardioverter-defibrillator
US841232017 août 20052 avr. 2013Cameron Health, Inc.Nontransvenous and nonepicardial methods of cardiac treatment and stimulus
US844739828 févr. 200721 mai 2013Cameron Health, Inc.Subcutaneous implantable cardioverter-defibrillator placement methods
US862628527 déc. 20127 janv. 2014Cameron Health, Inc.Method and devices for performing cardiac waveform appraisal
US865775615 févr. 201125 févr. 2014Cardiac Pacemakers, Inc.Implantable device employing movement sensing for detecting sleep-related disorders
US87187931 août 20066 mai 2014Cameron Health, Inc.Electrode insertion tools, lead assemblies, kits and methods for placement of cardiac device electrodes
US878160217 juin 201315 juil. 2014Cameron Health, Inc.Sensing vector selection in a cardiac stimulus device with postural assessment
US878802326 mai 200622 juil. 2014Cameron Health, Inc.Systems and methods for sensing vector selection in an implantable medical device
US884319620 sept. 201123 sept. 2014Cardiac Pacemakers, Inc.Subcutaneous cardiac sensing and stimulation system
US891574123 août 201123 déc. 2014Cardiac Pacemakers, Inc.Sleep quality data collection and evaluation
US894280211 févr. 200827 janv. 2015Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US896553018 juin 201424 févr. 2015Cameron Health, Inc.Implantable cardiac devices and methods using an x/y counter
US902296221 oct. 20045 mai 2015Boston Scientific Scimed, Inc.Apparatus for detecting and treating ventricular arrhythmia
US91385894 avr. 201422 sept. 2015Cameron Health, Inc.Apparatus and method for identifying atrial arrhythmia by far-field sensing
US914468330 oct. 200629 sept. 2015Cameron Health, Inc.Post-shock treatment in a subcutaneous device
US914964510 mars 20146 oct. 2015Cameron Health, Inc.Methods and devices implementing dual criteria for arrhythmia detection
US915548517 déc. 201413 oct. 2015Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US921628418 mars 201422 déc. 2015Cameron Health, Inc.Electrode insertion tools, lead assemblies, kits and methods for placement of cardiac device electrodes
US9345888 *9 mars 200724 mai 2016Cardiac Pacemakers, Inc.MRI compatible implantable medical devices and methods
US935796929 juil. 20157 juin 2016Cameron Health, Inc.Sensing vector selection in a cardiac stimulus device with postural assessment
US936467713 juin 201414 juin 2016Cameron Health, Inc.Systems and methods for sensing vector selection in an implantable medical device
US942139011 sept. 201523 août 2016Cameron Health Inc.Methods and devices implementing dual criteria for arrhythmia detection
US952228327 août 201520 déc. 2016Cameron Health Inc.Apparatus and method for identifying atrial arrhythmia by far-field sensing
US952228424 févr. 201620 déc. 2016Cameron Health Inc.Defibrillation pacing circuitry
US955525915 sept. 201531 janv. 2017Cameron Health Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US957906511 mars 201428 févr. 2017Cameron Health Inc.Cardiac signal vector selection with monophasic and biphasic shape consideration
US974436610 mai 201629 août 2017Cameron Health, Inc.Sensing vector selection in a cardiac stimulus device with postural assessment
US20020035380 *27 août 200121 mars 2002Cameron Health, Inc.Power supply for an implantable subcutaneous cardioverter-defibrillator
US20020042629 *27 août 200111 avr. 2002Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US20020049476 *27 août 200125 avr. 2002Cameron Health, Inc.Biphasic waveform anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20020052636 *27 août 20012 mai 2002Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with low-profile installation appendage and method of doing same
US20020068958 *27 août 20016 juin 2002Cameron Health, Inc.Radian curve shaped implantable cardioverter-defibrillator canister
US20020072773 *27 août 200113 juin 2002Cameron Health, Inc.Duckbill-shaped implantable cardioverter-defibrillator canister and method of use
US20020091414 *5 nov. 200111 juil. 2002Cameron Health, Inc.Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20020095184 *5 nov. 200118 juil. 2002Bardy Gust H.Monophasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20020107544 *5 nov. 20018 août 2002Cameron Health, Inc.Current waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20020107545 *5 nov. 20018 août 2002Cameron Health, Inc.Power supply for a subcutaneous implantable cardioverter-defibrillator
US20020107546 *5 nov. 20018 août 2002Cameron Health, Inc.Packaging technology for non-transvenous cardioverter/defibrillator devices
US20020107548 *5 nov. 20018 août 2002Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US20020120299 *5 nov. 200129 août 2002Cameron Health, Inc.Current waveforms for anti-tachycardia pacing for a subcutaneous implantable cardioverter- defibrillator
US20030088278 *5 nov. 20018 mai 2003Cameron Health, Inc.Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator
US20030088280 *5 nov. 20018 mai 2003Cameron Health, Inc.Low power A/D converter
US20030088282 *5 nov. 20018 mai 2003Cameron Health, Inc.Defibrillation pacing circuitry
US20030088283 *5 nov. 20018 mai 2003Ostroff Alan H.Simplified defibrillator output circuit
US20030114887 *31 janv. 200319 juin 2003Fanuc, LtdMethod and apparatus for the monitoring and treatment of spontaneous cardiac arrhythmias
US20030212436 *13 juin 200313 nov. 2003Brown Ward M.Apparatus for detecting and treating ventricular arrhythmia
US20040172071 *1 mars 20042 sept. 2004Cameron Health, Inc.Subcutaneous only implantable cardioverter-defibrillator and optional pacer
US20040186529 *19 mars 200423 sept. 2004Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with highly maneuverable insertion tool
US20040199082 *3 avr. 20037 oct. 2004Ostroff Alan H.Selctable notch filter circuits
US20040210293 *6 mai 200421 oct. 2004Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with insertion tool
US20040210294 *6 mai 200421 oct. 2004Cameron Health, Inc.Subcutaneous electrode for transthoracic conduction with low profile installation appendage
US20040215239 *8 avr. 200428 oct. 2004Mike FavetImplantable sudden cardiac death prevention device with reduced programmable feature set
US20040215240 *8 avr. 200428 oct. 2004Lovett Eric G.Reconfigurable subcutaneous cardiac device
US20040215258 *8 avr. 200428 oct. 2004Lovett Eric G.Subcutaneous cardiac rhythm management
US20040215308 *21 mai 200428 oct. 2004Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthoracic conduction
US20040230229 *13 juin 200318 nov. 2004Lovett Eric G.Hybrid transthoracic/intrathoracic cardiac stimulation devices and methods
US20040230230 *19 juin 200318 nov. 2004Lindstrom Curtis CharlesMethods and systems involving subcutaneous electrode positioning relative to a heart
US20040230243 *17 déc. 200318 nov. 2004Paul HaefnerNoise canceling cardiac electrodes
US20040236379 *8 juin 200425 nov. 2004Cameron Health, Inc.Apparatus and method of arrhythmia detection in a subcutaneous implantable cardioverter/defibrillator
US20040254611 *1 juin 200416 déc. 2004Cameron Health, Inc.Method and devices for performing cardiac waveform appraisal
US20040254613 *27 mai 200416 déc. 2004Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US20040260353 *9 juil. 200423 déc. 2004Cameron Health, Inc.Radian curve shaped implantable cardioverter-defibrillator canister
US20050004615 *24 févr. 20046 janv. 2005Sanders Richard S.Reconfigurable implantable cardiac monitoring and therapy delivery device
US20050010251 *5 nov. 200113 janv. 2005Cameron Health, Inc.Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator
US20050021093 *17 juin 200427 janv. 2005Team Brown, LlcSubcutaneous lead system for detection and treatment of malignant ventricular arrhythmia
US20050049643 *5 nov. 20013 mars 2005Cameron Health, Inc.Power supply for a subcutaneous implantable cardioverter-defibrillator
US20050049644 *27 juil. 20043 mars 2005Cameron Health, Inc.Multiple electrode vectors for implantable cardiac treatment devices
US20050065559 *9 nov. 200424 mars 2005Cameron Health, Inc.Monophasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20050107835 *19 nov. 200419 mai 2005Cameron Health, Inc.Ceramics and/or other material insulated shell for active and non-active S-ICD can
US20050115561 *17 sept. 20042 juin 2005Stahmann Jeffrey E.Patient monitoring, diagnosis, and/or therapy systems and methods
US20050119705 *5 nov. 20012 juin 2005Cameron Health, Inc.Cardioverter-defibrillator having a focused shocking area and orientation thereof
US20050131464 *24 sept. 200416 juin 2005Heinrich Stephen D.Apparatus for detecting and treating ventricular arrhythmia
US20050131466 *3 févr. 200516 juin 2005Cameron Health, Inc.H-bridge with sensing circuit
US20050137625 *9 nov. 200423 juin 2005Cameron Health, Inc.Power supply for a subcutaneous implantable cardioverter-defibrillator
US20050137637 *21 janv. 200523 juin 2005Cameron Health, Inc.Biphasic waveform for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20050143776 *21 oct. 200430 juin 2005Cardiac Pacemakers, Inc.Apparatus for detecting and treating ventricular arrhythmia
US20050143778 *18 févr. 200530 juin 2005Cameron Health, Inc.Current waveforms for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20050192505 *2 mai 20051 sept. 2005Cameron Health, Inc.Method for discriminating between ventricular and supraventricular arrhythmias
US20050192507 *2 mai 20051 sept. 2005Cameron Health, Inc.Multiple electrode vectors for implantable cardiac treatment devices
US20050192639 *22 avr. 20051 sept. 2005Cameron Health, Inc.Flexible subcutaneous implantable cardioverter-defibrillator
US20050240113 *30 juin 200527 oct. 2005Cameron Health, Inc.Low power A/D converter
US20050277990 *17 août 200515 déc. 2005Cameron Health, Inc.Current waveforms for anti-tachycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20050288714 *7 juin 200529 déc. 2005Cameron Health, Inc.Defibrillation pacing circuitry
US20060001070 *3 mai 20055 janv. 2006Samsung Electronics Co., Ltd.Capacitor of a memory device and fabrication method thereof
US20060004416 *2 sept. 20055 janv. 2006Cameron Health, Inc.Canister designs for implantable cardioverter-defibrillators
US20060009807 *12 sept. 200512 janv. 2006Cameron Health, Inc.Simplified defibrillator output circuit
US20060025826 *29 sept. 20052 févr. 2006Cameron Health, Inc.Subcutaneous implantable cardioverter-defibrillator employing a telescoping lead
US20060030893 *9 août 20049 févr. 2006Medtronic, Inc.Means for increasing implantable medical device electrode surface area
US20060036289 *14 oct. 200516 févr. 2006Cameron Health, Inc.Optional use of a lead for a unitary subcutaneous implantable cardioverter-defibrillator
US20060089681 *21 oct. 200427 avr. 2006Cameron Health, Inc.Implantable medical device
US20060116595 *29 nov. 20041 juin 2006Cameron Health, Inc.Method for defining signal templates in implantable cardiac devices
US20060116725 *29 nov. 20041 juin 2006Cameron Health, Inc.Method and apparatus for beat alignment and comparison
US20060122676 *6 déc. 20048 juin 2006Cameron Health, Inc.Apparatus and method for subcutaneous electrode insertion
US20060167503 *25 janv. 200527 juil. 2006Cameron Health, Inc.Method for adapting charge initiation for an implantable cardioverter-defibrillator
US20060167504 *25 janv. 200527 juil. 2006Cameron Health, Inc.Devices for adapting charge initiation for an implantable cardioverter-defibrillator
US20060229682 *6 juin 200612 oct. 2006Cameron Health, Inc.Power supply for an implantable subcutaneous cardioverter-defibrillator
US20060235479 *12 juin 200619 oct. 2006Cameron Health, Inc.Monophasic waveform for anti-bradycardia pacing for a subcutaneous implantable cardioverter-defibrillator
US20060241698 *26 avr. 200526 oct. 2006Cameron Health, Inc.Methods and implantable devices for inducing fibrillation by alternating constant current
US20070021791 *28 sept. 200625 janv. 2007Cameron Health, Inc.Transthoracic impedance measurement in a subcutaneous device
US20070032829 *4 août 20058 févr. 2007Cameron Health, Inc.Methods and devices for tachyarrhythmia sensing and high-pass filter bypass
US20070049979 *27 oct. 20061 mars 2007Cameron Health, Inc.Bradycardia pacing in a subcutaneous device
US20070055314 *30 oct. 20068 mars 2007Cameron Health, Inc.Post-shock treatment in a subcutaneous device
US20070135847 *12 déc. 200514 juin 2007Kenknight Bruce HSubcutaneous defibrillation system and method using same
US20070142865 *28 févr. 200721 juin 2007Cameron Health, Inc.Subcutaneous Implantable Cardioverter-Defibrillator Placement Methods
US20070179537 *27 févr. 20072 août 2007Cameron Health, Inc.Implantable Cardioverter-Defibrillator With Post-Shock Reset
US20070239223 *31 mars 200611 oct. 2007Engmark David BFeedthrough array for use in implantable medical devices
US20070260282 *7 mai 20078 nov. 2007Taylor William JFeedthrough apparatus with noble metal-coated leads
US20070276445 *26 mai 200629 nov. 2007Cameron Health, Inc.Systems and methods for sensing vector selection in an implantable medical device
US20070276452 *26 mai 200629 nov. 2007Cameron Health, Inc.Implantable medical device systems having initialization functions and methods of operation
US20080015644 *14 juil. 200617 janv. 2008Cameron Health, Inc.End of life battery testing in an implantable medical device
US20080077030 *26 sept. 200627 mars 2008Cameron Health, Inc.Signal analysis in implantable cardiac treatment devices
US20080132965 *11 févr. 20085 juin 2008Cameron Health, Inc.Method for Discriminating Between Ventricular and Supraventricular Arrhythmias
US20080140139 *31 oct. 200712 juin 2008Heinrich Stephen DApparatus for detecting and treating ventricular arrhythmia
US20080208276 *28 févr. 200728 août 2008Cardiac Pacemakers, Inc.Induced Current Measurement Systems And Methods
US20080221638 *9 mars 200711 sept. 2008Cardiac Pacemakers, Inc.MRI Compatible Implantable Medical Devices and Methods
US20080228092 *14 mars 200718 sept. 2008Wedan Steven RCardiac Sensing by Implantable Medical Devices During Magnetic Resonance Imaging
US20090163974 *4 mars 200925 juin 2009Medtronic, Inc.Feedthrough apparatus with noble metal-coated leads
US20100010560 *4 mars 200914 janv. 2010Medtronic, Inc.Feedthrough apparatus with noble metal-coated leads
US20110084714 *14 déc. 201014 avr. 2011Cardiac Pacemakers, Inc.Induced Current Measurement Systems And Methods
US20110137197 *15 févr. 20119 juin 2011Stahmann Jeffrey EImplantable Device Employing Movement Sensing for Detecting Sleep-Related Disorders
US20110192645 *19 avr. 201111 août 2011Medtronic, Inc.Feedthrough Apparatus with Noble Metal-Coated Leads
US20160256695 *12 mai 20168 sept. 2016Cardiac Pacemakers, Inc.Mri compatible implantable medical devices and methods
DE19930267A1 *25 juin 19994 janv. 2001Biotronik Mess & TherapiegDefibrillator has implantable electrode set, implantable electrically conducting housing connected as electrode and connected to another electrode in form of vena cava electrode
DE19930267B4 *25 juin 19995 oct. 2006Biotronik Gmbh & Co. KgDefibrillator
EP1318856B1 *14 sept. 200116 juil. 2014Cameron Health, Inc.Subcutaneous only implantable cardioverter-defibrillator and optional pacer
EP1584351A1 *21 nov. 200112 oct. 2005Medtronic, Inc.Apparatus for detecting and treating ventricular arrhythmia
EP1759732A1 *21 nov. 20017 mars 2007Medtronic, Inc.Apparatus for detecting and treating ventricular arrhythmia
EP2764892A1 *14 sept. 200113 août 2014Cameron Health, Inc.Subcutaneous only implantable cardioverter-defibrillator and optional pacer
WO1999046002A112 mars 199916 sept. 1999Intermedics Inc.Defibrillator housing with conductive polymer coating
WO2002041946A3 *21 nov. 20016 févr. 2003Medtronic IncApparatus for detecting and treating ventricular arrhythmia
WO2003039656A1 *28 oct. 200215 mai 2003Cameron Health, Inc.Subcutaneous electrode with improved contact shape for transthorasic conduction
WO2003089059A2 *4 avr. 200330 oct. 2003Cameron Health IncSubcutaneous cardiac stimulator device with small contact surface electrodes
WO2003089059A3 *4 avr. 20034 déc. 2003Cameron Health IncSubcutaneous cardiac stimulator device with small contact surface electrodes
WO2004091715A1 *5 avr. 200428 oct. 2004Cardiac Pacemakers, Inc.Methods and systems involving subcutaneous electrode positioning relative to a heart
WO2004091720A3 *9 avr. 20043 févr. 2005Cardiac Pacemakers IncSubcutaneous cardiac device
Classifications
Classification aux États-Unis607/5, 607/119, 607/36
Classification internationaleA61N1/05, A61N1/39
Classification coopérativeA61N1/3956, A61N1/0563, A61N1/3918
Classification européenneA61N1/39B, A61N1/05N1, A61N1/39M
Événements juridiques
DateCodeÉvénementDescription
21 janv. 1999ASAssignment
Owner name: NORWEST BUSINESS CREDIT, INC., MINNESOTA
Free format text: SECURITY INTEREST;ASSIGNOR:ANGEION CORPORATION;REEL/FRAME:009693/0097
Effective date: 19990118
3 déc. 1999ASAssignment
Owner name: ANGEION CORPORATION, MINNESOTA
Free format text: RELEASE OF SECURITY INTEREST;ASSIGNOR:NORWEST BUSINESS CREDIT, INC. (N/K/A WELLS FARGO BUSINESS CREDIT, INC.);REEL/FRAME:010470/0293
Effective date: 19991202
5 sept. 2000REMIMaintenance fee reminder mailed
25 janv. 2001SULPSurcharge for late payment
25 janv. 2001FPAYFee payment
Year of fee payment: 4
1 sept. 2004REMIMaintenance fee reminder mailed
11 févr. 2005LAPSLapse for failure to pay maintenance fees
12 avr. 2005FPExpired due to failure to pay maintenance fee
Effective date: 20050211